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Suggest Treatment For Enlarged Prostate

Posted on Wed, 2 Jul 2014

Question: hi
my father age is 67. last two years he was diagonised prostatomegally .heis taken alfusin. at present prostatic measures 4.51*3.62*3.25 and volume 27.76 ml . pvr volume insignificant . psa level 4. radiologist suggest grade 1 prostatomegally. now he suffers in uti and frequency of infection is high several times blood comes out with urin . what is the better treatment for him?

Answered by Dr. Dr. P. T. Patil (18 minutes later)

Brief Answer:
Needs proper Evaluation.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that your father has grade one Enlarged Prostate.

He is already taking Alfusin which is alpha one adrenergic receptor blocker that helps to relax the smooth muscles in bladder neck and prostate and there by help to improve urine flow.

Since he is getting repeated episodes of UTI and hematuria it is advisable to get his urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.

In the mean while start him broad spectrum antibiotics like Cefexine along with urinary antiseptic like Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report. You can add Dutasteride along with Alfusin (Alfusin -D)This will help to reduce the size and vascularity of the prostate.

Hope I have answered your query ,please feel free to ask if you have more questions ,
I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (1 hour later)

todays clinical investigation result a follows psa 5.15( previos 4 on july 2012/2.56 on march 2013), pvr insignificant , urine culture e coli colony count 10000 cfu/ml, sensitive to co-trimaxozole,norfloxacin,ciprofloxacin,ofloxacin,levofloxacin,amikacin,gentamycin,doxycycline,chloramphenicol, pus cells present 20-22/hpf,rbc 0-1/hpf,epithelial 4-5/hpf what medicine be advised for him? if any surgery needed for prostate gland? what is the main reason behind frequent uti?please advise.

Answered by Dr. Dr. P. T. Patil (3 hours later)

Brief Answer:
Prostatomegaly is cause for getting repeated UTI.

Detailed Answer:
Hello
Thanks for follow up.His recent PSA is reported to be marginally high but this could be due to mild enlargement of prostate and infection.

You can give him Norfloxacin twice daily .

If he gets repeated episodes of UTI I would advise to get endoscopic surgery(TURP) done .This will help to improve his urine flow and prevent getting UTI repeatedly.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (10 hours later)

how many days he will take norfloxacin or if he takeslevofloxacin what should be the doses(daily&no of days)? and which one is better for him either norfloxacin or levofloxacin?

Answered by Dr. Dr. P. T. Patil (42 minutes later)

Brief Answer:
Both are equally effective .

Detailed Answer:
Hello
Thanks for follow up.
Both the drug are of the same group.You can take Norfloxacin twice daily for 10 days .Repeat routine urine test and continue the same drug for one more week if urine examination still reveals presence of infection.
Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar